河北隆化地区异常妊娠结局孕妇弓形虫感染血清学调查

Serological survey of Toxoplasma gondii infection in women with adverse pregnancy outcomes in Longhua region,Hebei Province

目的了解河北省隆化地区异常妊娠结局孕妇弓形虫感染状况。方法选择2013-1-2016-6隆化县妇幼保健院就诊的异常妊娠结局孕妇393例为调查对象,根据检测结果分为急性感染组、既往感染组和活动性感染组,正常对照组为无异常妊娠史的孕妇256例。采用酶联免疫吸附实验检测各组孕妇血清弓形虫IgM、IgG抗体。采用问卷调查方式对各组孕妇进行弓形虫感染危险因素调查。结果异常妊娠结局孕妇弓形虫感染率为27.23%(107/393),显著高于正常对照组的8.20%(21/256),差异有统计学意义(χ~2=35.46,P<0.01)。异常妊娠结局孕妇急性感染率为6.87%(27/393)、既往感染率为18.58%(73/393)、活动性感染率为2.54%(10/393),分别高于正常对照组的1.17%(3/256)、7.03%(18/256)和0(0/256),差异均有统计学意义(χ~2=11.43、17.15、7.90,P均<0.01)。感染组中从事接触生肉的职业、饲养猫狗宠物、品尝生肉馅、菜板生熟不分、常吃涮锅或烧烤、经常在外就餐的比例显著高于非感染组,差异均有统计学意义(χ2=12.08、29.23、8.55、13.41、7.28、6.06,P均<0.05)。结论本地区异常妊娠结局孕妇弓形虫感染率较高,避免与宠物密切接触、不食用未煮熟的肉类以及加强个人卫生防护等是避免弓形虫感染的重要环节。

Objective To understand the status of Toxoplasma gondii infection in women with adverse pregnancy outcomes in Longhua region,Hebei Province. Methods A total of 393 women with adverse pregnancy outcomes were chosen as respon-dents in the Longhua County Maternal and Child Health Care Center between January 2013 and June 2016 and were divided into an acute infection group,a previous infection group,and an active infection group according to the test results. Totally 256 wom-en without adverse pregnancy outcomes were selected as a control group. IgM and IgG antibodies to T. gondii were detected by using ELISA in each group. The risk factors of T. gondii infection were surveyed by questionnaires. Results The T. gondii infec-tion rate of the women with adverse pregnancy outcomes was 27.23%（107/393）,which was significantly higher than 8.20%（21/256）in the control group（χ2=35.46,P〈0.01）. The rates of acute infection,previous infection,active infection in the wom-en with adverse pregnancy outcomes were 6.87%（27/393）,18.58%（73/393）,and 2.54%（10/393）respectively,which was significantly higher than those[1.17%（3/256）,7.03%（18/256）,0（0/256）]in the control group（χ2=11.43,17.15,7.90 re-spectively,P〈0.01）. The ratios of the career in contact with raw meat,feeding pets（dog and cat）,tasting raw meat,chopping board regardless of uncooked or cooked food,frequently eating rinsing boiler or barbecue,frequently eating outside of the wom-en with T. gondii infection were significantly higher than those of the women without T. gondii infection（χ2 =12.08,29.23, 8.55,13.41,7.28,6.06 respectively,P〈0.01 or 0.05）. Conclusions T. gondii infection could lead to serious adverse preg-nancy outcomes. Therefore,to avoid contacting with pets,not eating undercooked food,and strengthening personal health pro-tection are the important keys to avoid T. gondii infection.